OBJECTIVES: Acute otitis media (AOM) is extremely common in young children, with 75% having at least one episode by one year of age. Streptococcus pneumoniae (Sp) and non-typeable Haemophilus influenzae (NTHi) are the two most commonly isolated pathogens in AOM cases. The 7-valent (PCV-7) and 13-valent (PCV-13) pneumococcal conjugate vaccines have similar carrier proteins and protect only against AOM caused by Sp serotypes contained in the vaccines. The 10-valent pneumococcal vaccine (PHiD-CV) has eight of its ten serotypes conjugated to protein D from NTHi and may be regarded as the first dual pneumococcal pathogen vaccine with a potential to prevent AOM caused by both Sp and NTHi.  We estimate the clinical and economic impact of these three vaccines on AOM outcomes in Canada. METHODS: A steady-state, population-based model with a one-year time horizon was developed and calibrated with Canadian epidemiologic and demographic data. The healthcare system perspective was considered assuming 100% vaccination coverage, no herd protection and a 3+1 vaccination schedule. One-way sensitivity analysis was preformed to assess the impact of changes in key model assumptions. RESULTS: At price parity, the annual AOM-related cost-savings to the Canadian healthcare system due to the implementation of a PHiD-CV vaccination program is estimated at $17.1M and $12.3M compared to PCV-7 and PCV-13 respectively. Compared to PCV-7, vaccination with PHiD-CV could prevent an additional 171,162 ambulatory visits for AOM, 144,632 antibiotic prescriptions for AOM, and 9,827 hospitalizations for myringotomy per year. Compared to PCV-13, PHiD-CV could prevent 123,385 ambulatory visits for AOM, 104,269 antibiotic prescriptions for AOM, and 7,084 hospitalizations for myringotomy per year. Sensitivity analyses indicate that efficacy against AOM have the biggest impact on model results. CONCLUSIONS: Implementation of a PHiD-CV vaccination program in Canada is projected to substantially reduce AOM burden compared to PCV-7 or PCV-13.